- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,513.56 / $8,511.38
| Facility | | $851.14 | $1,513.56 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $10,715.19 / $11,220.18
| Facility | | $9,120.11 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,905.46 / $2,238.72
| Facility | | $1,318.26 | $1,905.46 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,570.40 / $2,570.40
| Facility | | $34.67 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,466.84 / $30,199.52
| Facility | | $602.56 | $4,466.84 | $30,199.52 |